Health ministry cuts ties with private administrators. Decision enters into effect immediately

Health ministry cuts ties
with private administrators
Decision enters into effect immediately
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The Ministry of Public Health (MoPH) has stopped using the services of three third-party administrators (TPAs) which managed claims of hospitalized patients at MoPH expense in private and public hospitals.

The three TPAs are GlobeMed, Nextcare, and MediVisa. Best Assistance was also managing MoPH patient claims until November 2018, when its contract expired.

The MoPH has called on its own inspection doctors to approve patient authorizations instead of the TPAs. The decision goes into effect on Feb. 8. The Cabinet will decide to terminate or amend the MoPH contracts with the TPAs, according to a health ministry memo.

TPAs managed MoPH hospitalized patients since 2016 following a tender requested by the ministry. The aim of this partnership with the private sector was to contain costs, according to MoPH.

The MoPH revealed last month that oversight, including its partnership with the TPAs, reduced hospital bills overruns from 11 percent of the 2016 hospitals budget to four percent in that of 2018.

There are some 80,000 medical claims per year, and the amounts that TPAs bill the MoPH depend on the claim.
Reported by Gisele Khalaf
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Date Posted: Feb 08, 2019